19. 面质

对峙

一般的对峙

当你决定对峙某人时，你感到什么样的情绪？许多人感到不安并担心对峙的结果。当别人对峙你时，你的感受如何？有时候是不是会感到威胁？可能会的。通常当我们使用“对峙”这个词时，我们会想到对立的双方和在对峙中不同意彼此的人。在这种情况下，被对峙的人可能会感到受到威胁并变得防御，而进行对峙的人可能会感到焦虑。

咨询中的对峙

作为咨询技巧的对峙与普遍认为的对峙不同。对峙的微技能涉及通过呈现某种信息来提高求助者的意识，这些信息是他们忽视或未能识别的。正确使用这一技能涉及以可接受的方式将信息带入求助者的意识中，这些信息可能是他们认为难以接受的，要么被避免，要么根本没有被注意到。

你如何帮助孩子吞下不好吃的药？你可以强行灌下去，也可以采用更温和的劝说方法。强行灌药的问题是，孩子可能会呕吐出来，而且你与年轻人的关系也不会改善。尊重孩子的感受可能会带来更积极的结果，而不是忽略他们的感受。同样，寻求咨询帮助的人应得到高度尊重，他们通常不喜欢被告知痛苦的真相。比喻地说，好的对峙艺术是帮助人们自愿吞下“苦药”，以便他们将其融入身体系统并消化它。

显然，对峙是一项难以掌握的技能，不应在本书中描述的先前技能成为你自然咨询风格的一部分之前尝试。你已经学过的技能，加上第17至28章中描述的技能，通常本身就足够了，使对峙变得不必要。此外，在建立信任关系之前避免使用对峙是很重要的，否则寻求帮助的人可能会感到受到威胁，并可能退出咨询过程而没有得到所需的帮助。

对峙前的自我反省

在使用对峙之前，审视自己的感受、动机和目标。问问自己：

“我是否因为不耐烦而不愿意让这个人按照自己的节奏前进而想要对峙？”
“我是否因为喜欢对峙而想要对峙？”
“我是否想要通过对峙将自己的价值观强加给对方？”
“我对他们感到愤怒并希望通过对峙表达我的愤怒？”

如果这些问题的答案是肯定的，那么对峙是不合适的。满足咨询师的个人需求不是对峙的正当理由。对峙最适当地用于其他微技能未能充分增加一个人的意识之后。

何时对峙

有多种情况适合对峙。例如，对峙适合于：

个人在回避一个似乎困扰他们的问题
个人未能认识到自己的自毁或自我挫败行为
个人未能认识到其行为的严重后果
个人发表自相矛盾的陈述
个人过度且不适当地陷入谈论过去或未来，无法专注于现在
个人反复讲述同一个故事，陷入循环
个人的非语言行为与其语言行为不符
需要关注求助者与咨询师之间关系中发生的事情，例如，依赖的发生，或个人撤退、表现出愤怒或其他情绪。

在这些情况下，咨询师可能会决定通过对峙来分享他们的感受、观察或注意到的内容。良好的对峙通常包括以下一个或多个要素：

对求助者所说内容的反思或简短总结，使他们感到被听到和理解
咨询师当前感受的陈述
咨询师具体观察到的内容的陈述，不进行解释

除了上述内容外，良好的对峙还以一种方式呈现，使求助者感到被尊重而非受到攻击或贬低。这些要点最好通过例子来解释。

说明对峙使用的示例

示例 1

求助者情况：求助者间接提到她对性取向的担忧。她简短地提到了几次性问题，然后立即转向谈论看似无关的琐事。 咨询师对峙：我感到困惑，因为我注意到你几次简短地提到你的性问题，然后就开始谈论完全不同的事情。注意：注意咨询师首先表达了她的感受——“我感到困惑”，然后给出了她注意到的具体情况。这种回应的威胁性最小，因为它只是反馈了咨询师观察到的内容，没有进行评判。

示例 2

求助者情况：一位愤怒的已分居丈夫因未获得子女监护权，威胁要在妻子和孩子们外出时烧毁家庭住宅。尽管被问及可能的后果，但他未能认识到威胁的严重后果。咨询师反映了他对妻子的愤怒和态度，这降低了他的一些愤怒，但他仍然感到极度报复心，并承认了这一点。 咨询师对峙：你对妻子如此愤怒，以至于想通过摧毁家庭住宅来伤害她。当我听到你威胁要这样做时，我非常担心，因为你会伤害你的妻子、孩子和你自己。显然，如果你烧毁房子，你的孩子会失去家园和财物，你可能会坐牢。注意：注意咨询师首先反映了求助者的情感和内容，接着表达了他自己的感受，最后通过给出可能后果的具体陈述完成了对峙。这一陈述不是咨询师的意见，而是对可能后果的准确描述。 伦理问题：当人员或财产可能受伤或受损时，咨询师有明确的责任采取行动防止这种情况发生（见第40章）。你可能希望在类似情况下与你的培训小组或督导讨论保密问题。

示例 3

求助者情况：求助者因与长期密友的关系危机来找咨询师。咨询师帮助她详细探讨过去的事件，因为她选择这样做。咨询师觉得继续关注过去不会再有任何进展。然而，尽管她说想讨论当前的危机，但她不断讲述过去的事件。 咨询师对峙：我感到困惑。我的印象是你想解决当前的危机，但你却不断谈论过去的事件。不幸的是，过去无法改变，但你可以改变当前发生的事情。注意：回应以咨询师的感受陈述开始——“我感到困惑”，接着反映了求助者想讨论当前危机的愿望，然后是咨询师观察到的具体情况：“你不断谈论过去的事件”。在这个例子中，咨询师添加了另一个可能对求助者有用的事实陈述：“不幸的是，过去无法改变，但你可以改变当前发生的事情”。记住：当过去的事件显著影响当前的思想和感受时，以建设性的方式处理过去事件是适当的。然而，如果一个人不恰当地、过度地使用过去的历史来避免面对当前的问题，建议的对峙是适当的。

示例 4

求助者情况：这里是一个咨询师回应的示例，针对一个不断重复自己、反复讲述相同内容的人。 咨询师对峙：我注意到我们似乎在兜圈子，所以我将总结一下我们谈到的内容……[这个陈述的结尾是一个总结]。注意：这个例子展示了如何通过指出重复行为来进行对峙。咨询师首先告诉她自己注意到的情况，然后进行了总结。通过这种方式对峙，咨询师可以增加求助者对自己行为的意识。随着意识的增加，求助者可能能够摆脱困境。然而，有时即使在对峙之后，求助者仍会坚持重复同样的内容。这时需要更强的对峙，咨询师可能会说：“我开始感到沮丧，因为我们又在走同一条路”。

示例 5

求助者情况：求助者说：“我在婚姻中感到非常幸福”，但说话时声音非常低沉，身体也瘫倒在椅子上。 咨询师对峙：我注意到你提到在婚姻中感到非常幸福时，声音听起来非常低沉，身体也瘫倒在椅子上。注意：在这里，咨询师通过反映她观察到的情况来进行对峙，没有对观察进行解释。这样，求助者可以自由地对反馈做出自己的解释。

总结

对峙的作用：对峙通过提供求助者可能未意识到的信息来增加他们的意识。对峙最好以关爱、谨慎和熟练的方式进行！

本章知识点阐述

对峙

概念与感受

一般对峙

定义：通常当我们使用“对峙”这个词时，我们会想到对立的双方和在对峙中不同意彼此的人。
感受：
- 被对峙者：被对峙的人可能会感到受到威胁并变得防御。
- 对峙者：进行对峙的人可能会感到焦虑。

咨询中的对峙

定义

咨询中的对峙：作为咨询技巧的对峙与普遍认为的对峙不同。对峙的微技能涉及通过呈现某种信息来提高求助者的意识，这些信息是他们忽视或未能识别的。

目的

提高意识：正确使用这一技能涉及以可接受的方式将信息带入求助者的意识中，这些信息可能是他们认为难以接受的，要么被避免，要么根本没有被注意到。

类比

类比：你如何帮助孩子吞下不好吃的药？你可以强行灌下去，也可以采用更温和的劝说方法。强行灌药的问题是，孩子可能会呕吐出来，而且你与年轻人的关系也不会改善。尊重孩子的感受可能会带来更积极的结果，而不是忽略他们的感受。
咨询中的应用：同样，寻求咨询帮助的人应得到高度尊重，他们通常不喜欢被告知痛苦的真相。比喻地说，好的对峙艺术是帮助人们自愿吞下“苦药”，以便他们将其融入身体系统并消化它。

技能要求

难度：对峙是一项难以掌握的技能，不应在本书中描述的先前技能成为你自然咨询风格的一部分之前尝试。
信任关系：在建立信任关系之前避免使用对峙是很重要的，否则寻求帮助的人可能会感到受到威胁，并可能退出咨询过程而没有得到所需的帮助。

对峙前的自我反省

自我检查

感受与动机：
- 你是否因为不耐烦而不愿意让这个人按照自己的节奏前进而想要对峙？
- 你是否因为喜欢对峙而想要对峙？
- 你是否想要通过对峙将自己的价值观强加给对方？
- 你是否对他们感到愤怒并希望通过对峙表达你的愤怒？
不合适的情况：如果这些问题的答案是肯定的，那么对峙是不合适的。满足咨询师的个人需求不是对峙的正当理由。

使用时机

时机：对峙最适当地用于其他微技能未能充分增加一个人的意识之后。

何时对峙

适用情况

回避问题：个人在回避一个似乎困扰他们的问题。
自毁行为：个人未能认识到自己的自毁或自我挫败行为。
严重后果：个人未能认识到其行为的严重后果。
自相矛盾：个人发表自相矛盾的陈述。
时间错位：个人过度且不适当地陷入谈论过去或未来，无法专注于现在。
重复循环：个人反复讲述同一个故事，陷入循环。
行为不一致：个人的非语言行为与其语言行为不符。
关系问题：需要关注求助者与咨询师之间关系中发生的事情，例如，依赖的发生，或个人撤退、表现出愤怒或其他情绪。

实施方法

反思与总结：对求助者所说内容的反思或简短总结，使他们感到被听到和理解。
表达感受：咨询师当前感受的陈述。
具体观察：咨询师具体观察到的内容的陈述，不进行解释。
尊重与接纳：良好的对峙还以一种方式呈现，使求助者感到被尊重而非受到攻击或贬低。

示例

示例 1

情境：求助者反复讲述同一个故事，无法聚焦当前问题。
对峙：咨询师可以说：“我注意到你一直在讲述同样的故事，但似乎没有关注当前的问题。你能谈谈你现在的感觉吗？”

示例 2

情境：求助者的行为与其言语不一致。
对峙：咨询师可以说：“我注意到你在说你想要改变，但你的行为似乎并没有反映出这一点。你能谈谈这是怎么回事吗？”

总结

尊重与理解：咨询中的对峙需要高度尊重和理解，避免将个人需求强加给求助者。
适时与适度：对峙应在其他微技能未能充分增加意识的情况下使用，并确保在建立信任关系的基础上进行。
具体与非解释：良好的对峙应包括对求助者所说内容的反思或总结，咨询师的当前感受，以及具体观察到的内容，避免解释和指责。

说明对峙使用的示例

示例 1

求助者情况：求助者间接提到她对性取向的担忧。她简短地提到了几次性问题，然后立即转向谈论看似无关的琐事。
咨询师对峙：我感到困惑，因为我注意到你几次简短地提到你的性问题，然后就开始谈论完全不同的事情。
注意：注意咨询师首先表达了她的感受——“我感到困惑”，然后给出了她注意到的具体情况。这种回应的威胁性最小，因为它只是反馈了咨询师观察到的内容，没有进行评判。

示例 2

求助者情况：一位愤怒的已分居丈夫因未获得子女监护权，威胁要在妻子和孩子们外出时烧毁家庭住宅。尽管被问及可能的后果，但他未能认识到威胁的严重后果。咨询师反映了他对妻子的愤怒和态度，这降低了他的一些愤怒，但他仍然感到极度报复心，并承认了这一点。
咨询师对峙：你对妻子如此愤怒，以至于想通过摧毁家庭住宅来伤害她。当我听到你威胁要这样做时，我非常担心，因为你会伤害你的妻子、孩子和你自己。显然，如果你烧毁房子，你的孩子会失去家园和财物，你可能会坐牢。
注意：注意咨询师首先反映了求助者的情感和内容，接着表达了他自己的感受，最后通过给出可能后果的具体陈述完成了对峙。这一陈述不是咨询师的意见，而是对可能后果的准确描述。
伦理问题：当人员或财产可能受伤或受损时，咨询师有明确的责任采取行动防止这种情况发生（见第40章）。你可能希望在类似情况下与你的培训小组或督导讨论保密问题。

示例 3

求助者情况：求助者因与长期密友的关系危机来找咨询师。咨询师帮助她详细探讨过去的事件，因为她选择这样做。咨询师觉得继续关注过去不会再有任何进展。然而，尽管她说想讨论当前的危机，但她不断讲述过去的事件。
咨询师对峙：我感到困惑。我的印象是你想解决当前的危机，但你却不断谈论过去的事件。不幸的是，过去无法改变，但你可以改变当前发生的事情。
注意：回应以咨询师的感受陈述开始——“我感到困惑”，接着反映了求助者想讨论当前危机的愿望，然后是咨询师观察到的具体情况：“你不断谈论过去的事件”。在这个例子中，咨询师添加了另一个可能对求助者有用的事实陈述：“不幸的是，过去无法改变，但你可以改变当前发生的事情”。
记住：当过去的事件显著影响当前的思想和感受时，以建设性的方式处理过去事件是适当的。然而，如果一个人不恰当地、过度地使用过去的历史来避免面对当前的问题，建议的对峙是适当的。

示例 4

求助者情况：这里是一个咨询师回应的示例，针对一个不断重复自己、反复讲述相同内容的人。
咨询师对峙：我注意到我们似乎在兜圈子，所以我将总结一下我们谈到的内容……[这个陈述的结尾是一个总结]。
注意：这个例子展示了如何通过指出重复行为来进行对峙。咨询师首先告诉她自己注意到的情况，然后进行了总结。通过这种方式对峙，咨询师可以增加求助者对自己行为的意识。随着意识的增加，求助者可能能够摆脱困境。然而，有时即使在对峙之后，求助者仍会坚持重复同样的内容。这时需要更强的对峙，咨询师可能会说：“我开始感到沮丧，因为我们又在走同一条路”。

示例 5

求助者情况：求助者说：“我在婚姻中感到非常幸福”，但说话时声音非常低沉，身体也瘫倒在椅子上。
咨询师对峙：我注意到你提到在婚姻中感到非常幸福时，声音听起来非常低沉，身体也瘫倒在椅子上。
注意：在这里，咨询师通过反映她观察到的情况来进行对峙，没有对观察进行解释。这样，求助者可以自由地对反馈做出自己的解释。

总结

对峙的作用：对峙通过提供求助者可能未意识到的信息来增加他们的意识。对峙最好以关爱、谨慎和熟练的方式进行！

学习总结

对峙的目的：对峙涉及将信息带入求助者的意识中，这些信息可能：
- 对他们来说难以接受，或者
- 被忽视或错过，需要他们在咨询中加以考虑，以使咨询尽可能有帮助。
有效的对峙：通常包括一个总结，接着是咨询师的感受陈述，最后是一个具体陈述，不进行解释。
效果：有效的对峙会让求助者感到被尊重，而不是受到攻击。

进一步阅读

Ivey, A.E., Ivey, M.B. & Zalaquett, C.P. 2015, "Empathic confrontation", in A.E. Ivey, M.B. Ivey & C.P. Zalaquett, Essentials of Intentional Interviewing: Counseling in a Multicultural World, 3rd edn, Cengage Learning, Boston, pp. 178—97.

19 Confrontation What do you feel emotionally when you decide to confront someone? Many people feel apprehensive and worry about the outcome of confrontation. What is it like for you when someone confronts you? Is it sometimes threatening? It may be. Generally when we use the word ‘confrontation’ we think in terms of opposing parties and of people disagreeing as they confront each other. In such a situation the person being confronted is likely to feel threatened and may become defensive, while the person doing the confronting is likely to feel anxiety. CONFRONTATION IN COUNSELLING Confrontation as a counselling skill is different from the generally perceived view of confrontation. The micro-skill of confrontation involves raising the awareness of the person seeking help by presenting to them information that in some way they are overlooking or failing to identify. Correct use of this skill involves bringing into the person’s awareness, in an acceptable way, information that they may consider to be unpalatable and which is either being avoided or is just not being noticed. How do you help a child to swallow medicine that doesn’t taste nice? You can either force it down the child’s throat or use a more gentle persuasive approach. The problem with trying to force the medicine down is that the child may well vomit it up and your relationship with the young person will not be improved. Respecting the child’s feelings is likely to have a more positive outcome than ignoring them. —s Similarly, people who seek counselling help deserve a high degree of ( respect, and they usually don’t like being told painful truths. Metaphorically speaking, the art of good confrontation is to help the person to swallow ‘bad medicine’ voluntarily, so that they can incorporate it into their bodily system and digest it. Confrontation is clearly a difficult skill to master and should not be attempted until the skills previously described in this book have become a natural part of your counselling style. The skills you have learnt already, together with the skills described in Chapters 17 to 28, are often sufficient in themselves, making confrontation unnecessary. Additionally, it is important to avoid using confrontation until a trusting relationship has been established, as otherwise the s person seeking help is likely to feel threatened and may withdraw from the counselling process without receiving the help they need. SELF-EXAMINATION BEFORE CONFRONTATION Before using confrontation, look within yourself to examine your feelings, motives and goals. Ask yourself: ‘Do 1 want to confront because 1 am impatient and not prepared to allow this person to move at their own pace?’; 'Do 1 want to confront because 1 enjoy confrontation?’; 'Am 1 wanting to use confrontation to put my own values onto the person? ; or ‘Am I feeling angry with them and wanting to express my anger through confrontation?’ If the answer to any of these questions is Yes’, then confrontation is inappropriate. Satisfying the counsellor’s own needs is no justification for confrontation. Confrontation is most appropriately used after the use of other micro-skills has failed to sufficiently increase a person’s awareness. WHEN TO CONFRONT 1 here are a number of situations in which confrontation is appropriate. For example, confrontation is appropriate where: • the person is avoiding a basic issue that appears to be troubling them • the person is failing to recognise their own self-destructive or self-defeating behaviour • the person is failing to recognise possible serious consequences of their behaviour • the person is making self-contradictory statements • the person is excessively and inappropriately locked into talking about the past or the future and is unable to focus on the present • the person is going around in circles by repeating the same story over and over • the person’s non-verbal behaviour does not match their verbal behaviour • attention needs to be given to what is going on in the relationship between the person seeking help and the counsellor; for example, where dependency is occurring, or where a person withdraws or shows anger or some other emotion towards the counsellor. In situations such as these, the counsellor may decide to confront the person by sharing with them what they feel, notice or observe. Good confrontation usually includes elements of some or all of the following: • a reflection or brief summaw of what the person has said, so that they feel heard and understood • a statement of the counsellor s present feelings • a concrete statement of what the counsellor has noticed or observed, given without interpretation. In addition to the above, good confrontation is presented in such a way that the person can feel OK rather than attacked or put down. These points are best explained by means of examples.

EXAMPLES TO ILLUSTRATE THE USE OF CONFRONTATION Example 1 The person seeking help had been referring obliquely to her concerns about her sexuality. She mentioned the sexual problem briefly several times and then immediately deflected away from it by talking about seemingly irrelevant trivia. Counsellor confrontation: Trn puzzled because I've noticed that several times you've briefly mentioned your sexual problem and then have started talking about something quite different.' Notice how the counsellor first expressed her feelings by saying Tm puzzled’, and then gave a concrete statement of what she had noticed occurring. This response is minimally threatening as it merely feeds back to the person what the counsellor has observed, without judgement. Example 2 An angry separated husband who had been denied custody of his children was threatening to bum down the matrimonial home when his wife and children were out. Even though he had been asked about possible consequences, he failed to recognise the serious consequences of his threat. The counsellor had reflected back his anger and attitude towards his wife. This had reduced his anger level but he still felt excessively vindictive and admitted to this. Counsellor confrontation: You are so furious with your wife that you want to hurt her by destroying the family home. I m very concerned when I hear you threatening to do this because you would hurt your wife, your children and yourself. Clearly, if you were to burn down the house your children would lose their home and possessions, and you might end up in jail.' Notice how the counsellor first reflected back the feelings and content of the person’s message, followed this by a statement of his own feelings, and completed the confrontation by giving a factual statement of likely consequences. 1 his latter statement was not a statement of the counsellor s opinion, but was an accurate statement of the likely consequences. There is also an ethical issue here. Where people or property could be injured or damaged the counsellor has a clear responsibility to take action to prevent this from occurring (see Chapter 40). You may wish to discuss the issue of confidentiality in a situation such as this with your training group or supervisor.

Example 3 The person seeking help had come to the counsellor as a result of a crisis in her current relationship with a longstanding close friend. The counsellor helped her to explore past events at length, as she chose to do that. It seemed to the counsellor that nothing further would be achieved by continuing to focus on the past. However, although the person said that she wanted to talk about her present crisis, she continually recounted past events. Counsellor confrontation: 'I am puzzled. My impression is that you want to resolve your present crisis and yet you continually talk about past events. Unfortunately, the past can't be changed but what you can change is what is happening in the present.' The response started with a statement of the counsellor’s feelings — Tm puzzled’ — followed by a reflection of the person’s desire to talk about her present crisis, and then a concrete statement of what the counsellor had observed: 4You continually talk about past events’. In this example the counsellor adds another factual statement which might be useful tor the person seeking help: 'Unfortunately, the past can’t be changed but what you can change is what is happening in the present’. Remember that it is appropriate for people to deal with past events in a constructive way where those events are significantly influencing present thoughts and feelings. However, the suggested confrontation would be appropriate if a person was in appropriately and excessively using past history to avoid facing present problems. Example 4 Here is an example of a counsellor response that addresses repetitive behaviour by a person who kept repeating herself by going over and over the same ground. Counsellor confrontation: ‘I've noticed that we seem to be going round in circles, so I'll summarise what we've talked about ... [the end of this statement is a summary).' This example demonstrates how the person was confronted with her repetitive behaviour. The counsellor first told her what she had noticed happening, and then gave a summary. By confronting in this way, a counsellor can increase the person’s awareness of what is happening. With increased awareness the person may be able to move out of the rut in which she is stuck. However, sometimes, even after confrontation, the person will persist in going around the track again and repeating the same details. It is here that stronger confrontation is needed and the counsellor might say, Tm starting to feel frustrated, because once again we are going around the same track’.

Example 5 The person seeking help said, 'I feel really happy in my marriage,' using a very depressed tone of voice and slumping down in her chair as she spoke. Counsellor confrontation: rl noticed that your voice sounded very flat and you slumped down in your chair when you said that you felt really happy in your marriage.' Here the counsellor confronted by reflecting back what they observed without putting an interpretation on their observation. The person was then free to make her own interpretation of the feedback given. In summary, confrontation increases the person’s awareness by providing them with information which they may have been unaware of. Confrontation is best done caringly, sparingly and skilfully!

Learning summary Confrontation involves bringing into the person's awareness information which: » may be unpalatable to them, or » may have been ignored or missed and needs to be considered by them if the counselling is to be optimally helpful. Effective confrontation often includes a summary, followed by a statement of the counsellor's feelings and a concrete statement given without interpretation. Effective confrontation leaves the person seeking help feeling OK and not attacked. Further reading Ivey, A.E., Ivey, M.B. &■ Zalaquett, C.P. 2015, "Empathic confrontation’, in A.E. Ivey, M.B. Ivey & C.P. Zalaquett, Essentials of Intentional Interviewing: Counseling in a Multicultural World, 3rd edn, Cengage Learning, Boston, pp. 178—97.